AMAUROSIS FUGAX

Definition
● The word ''amaurosis'' comes from Greek language
which means to 'darken or obscured'
● The word 'fugax' means 'fleeing'.
● Its a sudden, temporary, partial or total loss of vision
from any cause.
 Aetiology
● Circulatory – Embolic
Hypoperfusion
Carotid & Cardiac emboli
Artherosclerotic carotid artery
● Occular – Keratitis
Angiospasm
● Neurological – SLE
Optic neuritis
Multiple sclerosis
 Atherosclerotic carotid artery
● Amaurosis fugax may present as a type of transient
ishcemic attack (TIA), during which an embolus
unilaterally obstructs the lumen of the retinal artery or
ophthalmic artery causing a decrease in blood flow to
the ipsilateral retina.
● Common source of these athero-emboli is an
atherosclerotic carotid artery. Severely
atherosclerotic carotid artery causes amaurosis fugax
due to its stenosis of blood flow, leading to ischemia.
 Cardiac Emboli
● Thrombotic emboli arising from the heart causes
luminal obstruction of the retinal, ophthalmic, and/or
ciliary arteries, causing decreased blood flow to the
ipsilateral retina

● examples being those arising due to (1) atrial

fibrillation, (2) valvular abnormalities including post-
rheumatic valvular disease, mitral valve prolapse, and a
bicuspid aortic valve, and (3) artrial myxomas.
 Temporary Vasospasm
● leads to decreased blood flow that can cause
amaurosis fugax. Generally, these episodes last no
longer that five minutes, and have been associated
with exercise
● Observations suggest that a systemic hemodynamic
challenge provoke[s] the release of vasospastic
substance in the rentinal vasculature of one eye."
 Symptoms
● Transient monocular vision loss that appears as a
"curtain'' coming down vertically into the field vision in
one eye;" however, this altitudinal visual loss is
relatively uncommon.
● Others includes a monocular blindness, dimming,
fogging, or blurring. Total or sectorial typically lasts
only a few seconds, but may last minutes or even
hours. Duration depends on the etiology of the vision
loss.
 Sign and Tests
● complete eye and neurological exam. In some cases,
an eye exam will reveal a bright spot where the clot
is blocking the retinal artery.
● A carotid ultrasound or magnetic resonance
angiography (MRA) scan should be done to evaluate
a blockage in the carotid artery.
● Routine blood tests such as cholesterol and blood
sugar should be done to check your risk for
atherosclerosis, which increases with high
cholesterol and diabetes.
 Treatments
● directed therapies to treat that underlying etiology
should be initiated
● If the amaurosis fugax is caused by an
atherosclerotic lesion, aspirin is indicated, and a
cardiac endarterectomy if the stenosis is surgically
accessible
Central Retinal Artery Occlusion
Branch Retinal Artery Occlusion
Brach Retinal Vein Occlusion